百会八阵穴和神道八阵穴杵针治疗脑卒中后抑郁的临床研究*

作者：罗渝民，王冬梅，黄治胜，阳 洋，潘 锐，卿剑明

单位：简阳市中医医院，四川 简阳 641400

引用：引用：罗渝民，王冬梅，黄治胜，阳洋，潘锐，卿剑明.百会八阵穴和神道八阵穴杵针治疗脑卒中后抑郁的临床研究[J].中医药导报,2025,31(9):102-106,116.

DOI：10.13862/j.cn43-1446/r.2025.09.017

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摘要：

目的：探讨百会八阵穴和神道八阵穴杵针治疗对脑卒中后抑郁（PSD）患者的影响，并评估其临床疗效。方法：采用随机对照试验（RCT）设计，纳入2021年7月至2024年4月收治的137例PSD患者，随机分为试验组68例和对照组69例。试验组采用杵针治疗，选择百会八阵穴和神道八阵穴为主穴，配合风池、膈俞穴，每周治疗5次，共4周；对照组口服帕罗西汀（20~50 mg/d），治疗4周。两组均于治疗前、治疗2周及4周后评估汉密尔顿抑郁量表（HAMD）、卒中专用生活质量量表（SS-QOL）、美国国立卫生研究院卒中量表（NIHSS）及血清5-羟色胺（5-HT）及多巴胺（DA）水平。结果：治疗过程中对照组脱落5例，试验组脱落4例，故两组最终均纳入64例患者。治疗2周、4周后，试验组患者HAMD评分显著低于对照组（P<0.01）。治疗4周后试验组总有效率（98.52%）高于对照组（69.57%）（P<0.01）。在生活质量方面，治疗4周后试验组患者SS-QOL各维度评分均显著优于对照组（P<0.05）。治疗2周、4周后试验组患者NIHSS评分降低幅度大于对照组（P<0.01）。治疗4周后试验组患者5-HT、DA水平提升均显著高于对照组（P<0.01）。结论：百会八阵穴和神道八阵穴杵针疗法可显著改善PSD患者的抑郁症状、生活质量和神经功能，其机制可能与调节单胺类神经递质有关，疗效优于帕罗西汀。

关键词：脑卒中后抑郁；杵针；百会八阵穴；神道八阵穴；帕罗西汀；5-羟色胺；多巴胺

Abstract：

Objective: To investigate the effect of pestle needle therapy at Baihui (GV20) Bazhen Points and Shendao (GV11) Bazhen points on patients with post-stroke depression (PSD) and evaluate its clinical efficacy. Methods: A randomized controlled trial (RCT) was conducted involving 137 PSD patients admitted between July 2021 and April 2024. Patients were randomly divided into an experimental group (n=68, receiving pestle needle therapy) and a control group (n=69, receiving oral paroxetine 20-50 mg/day). The experimental group received pestle needle therapy primarily at Baihui Bazhen Points and Shendao Bazhen points, supplemented by Fengchi (GB20) and Geshu (BL17) points, five times per week for 4 weeks. The Hamilton Depression Rating Scale (HAMD), Stroke-Specific Quality of Life Scale (SS-QOL), National Institutes of Health Stroke Scale (NIHSS), and serum levels of 5-hydroxytryptamine (5-HT) and dopamine (DA) were assessed before treatment, at 2 weeks, and after 4 weeks of treatment. Results: During the trial, 5 patients in the control group and 4 in the experimental group were lost to follow-up. Consequently, 64 patients from each group were finally included in the analysis. After 2 and 4 weeks of treatment, the HAMD scores in the experimental group were significantly lower than that in the control group (P<0.01). The total effective rate was 98.52% in the experimental group, significantly higher than 69.57% in the control group (P<0.01). Regarding quality of life, the SS-QOL scores across various dimensions in the experimental group were significantly better than those in the control group after 4 weeks (P<0.05). The reduction in NIHSS scores was greater in the experimental group than in the control group after 2 and 4 weeks(P<0.01). The increases in serum 5-HT and DA levels were significantly greater in the experimental group than in the control group (P<0.01). Conclusion: Pestle needle therapy at Baihui Bazhen Points and Shendao Bazhen points can significantly improve depressive symptoms, quality of life, and neurological function in PSD patients. Its mechanism may be related to the regulation of monoamine neurotransmitters. The therapeutic effect is superior to paroxetine.

Key words：post-stroke depression; pestle needle therapy; Baihui (GV20) Bazhen points; Shendao (GV11) Bazhen points; paroxetine; 5-hydroxytryptamine (5-HT); dopamine (DA)

发布时间：2026-01-08

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